Minoxidil in a once-a-day step-3 antihypertensive program.

Area of Science:

• Cardiology
• Pharmacology

Background:

• Hypertension management often involves multiple daily medications, impacting patient compliance.
• Convenience and minimal side effects are crucial for successful long-term hypertension treatment.

Purpose of the Study:

• To evaluate the efficacy and tolerability of a simplified once-daily regimen for moderate to severe hypertension.
• To assess the impact of a once-daily combination therapy on blood pressure control and patient adherence.

Main Methods:

• A cohort of 30 patients with moderate to severe hypertension, previously on multiple daily doses, were treated with a once-daily regimen.
• Treatment initiated with nadolol (160 mg) and chlorthalidone (50 mg), with minoxidil added incrementally if diastolic blood pressure exceeded 90 mmHg.
• Blood pressure monitored regularly, including 24-hour ambulatory monitoring, to assess 24-hour control.

Main Results:

• Significant reduction in average blood pressure from 170.9/107.0 mmHg to 138.8/86.7 mmHg within three months of adding minoxidil.
• Sustained blood pressure control observed at six months, with readings around 140.9/86.3 mmHg.
• Hypertrichosis was a common side effect, primarily affecting female patients; small, asymptomatic pericardial effusions occurred in five patients.

Conclusions:

• A once-daily regimen of minoxidil, nadolol, and chlorthalidone offers an effective and convenient treatment for moderate to severe hypertension.
• The simplified dosing regimen improved blood pressure control and patient compliance, with most patients choosing to continue treatment due to mild side effects.